Blood pressure medications: Can they raise my triglycerides?

Can some blood pressure medications cause an increase in triglyceride levels?

- Don / North Carolina

Answer

Yes, some blood pressure medications can affect cholesterol levels, including triglycerides.

Beta blockers — most notably the older ones such as propranolol, atenolol and metoprolol — can slightly increase triglyceride levels and decrease high-density lipoprotein (HDL, or "good") cholesterol. Typically this occurs in people who are more predisposed to or who already have metabolic syndrome — a cluster of conditions that includes high blood pressure, high blood sugar, excess fat around the abdomen and high cholesterol. Newer beta blockers such as carvedilol and nebivolol are less often associated with these changes.

Thiazide diuretics in higher doses also can slightly increase triglycerides as well as total cholesterol. Some observational studies have linked such changes with an increase in cardiovascular events, such as heart attacks. However, controlled trials haven't corroborated this, and in fact, have found a reduction in cardiovascular events with diuretics. Still, meta-analyses of the older beta blocker drugs conclude that these agents should not be initial drugs of choice in the treatment of high blood pressure except in specific instances such as to prevent recurrent coronary artery disease, to manage heart failure and to treat certain arrhythmias.

Before making any changes in your drug therapy, discuss this with your doctor.

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